Article Text

Download PDFPDF
Changes in all-cause and cause-specific mortality by occupational skill during COVID-19 epidemic in Spain
  1. Damián González-Beltrán1,
  2. Marta Donat1,
  3. Julieta Politi1,
  4. Elena Ronda2,3,
  5. Gregorio Barrio1,3,
  6. María José Belza1,3,
  7. Enrique Regidor4
  1. 1National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
  2. 2Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
  3. 3CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  4. 4Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
  1. Correspondence to Damián González-Beltrán, National School of Public Health, Instituto de Salud Carlos III, Madrid 28029, Spain; damianglezbel{at}gmail.com

Abstract

Background There is little information on the differential impact of the COVID-19 pandemic on mortality by occupation. The objective was to examine changes in mortality during the COVID-19 period compared with the prepandemic period in different occupational groups in Spain.

Methods Average mortality in the entire period 2020–2021, and each of its semesters, was compared, respectively, with the average mortality in the entire period 2017–2019, and the corresponding semester (first or second) of this last period, across occupational skill levels. For this, age-standardised death rates and age-adjusted mortality rate ratios (MRRs) obtained through Poisson regression were used. Data were obtained from the National Institute of Statistics and the Labour Force Survey.

Results The excess all-cause mortality during the 2020–2021 pandemic period by the MRR was higher in low-skilled (1.18, 95% CI 1.16 to 1.20) and medium-skilled workers (1.14; 95% CI 1.13 to 1.15) than high-skilled workers (1.04; 95% CI 1.02 to 1.05). However, the greatest excess mortality was observed in low-skilled workers in 2020 and in medium-skilled workers in 2021. Focusing on causes of death other than COVID-19, low-skilled workers showed the highest MRR from cardiovascular diseases (1.31; 95% CI 1.26 to 1.36) and high-skilled workers the lowest (1.02; 95% CI 0.98 to 1.02). However, this pattern was reversed for mortality from external causes, with low-skilled workers showing the lowest MRR (1.04; 95% CI 0.97 to 1.09) and high-skilled workers the highest (1.08; 95% CI 1.03 to 1.13).

Conclusion Globally, in Spain, during the 2020–2021 COVID-19 epidemic period, low-skilled workers experienced a greater excess all-cause mortality than other occupational groups, but this was not the case during the entire epidemic period or for all causes of death.

  • MORTALITY
  • DEATH
  • OCCUPATIONAL HEALTH
  • COVID-19

Data availability statement

Data are available upon reasonable request.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available upon reasonable request.

View Full Text

Footnotes

  • Contributors DG-B and MD designed the study, collected data, did the analyses and drafted the manuscript. JP and ERo contributed to statistical analysis and data management. GB, MJB and ERe revised the manuscript and provided intellectual content. All authors contributed to the interpretation of the results. All authors have seen and approved the final version.

  • Funding Spanish Ministry of Health, National Drug Plan (2021I034); a grant (ENPY 136/22-M3 FORMATIVO-2) from the Instituto de Salud Carlos III, Madrid, Spain

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.